Health Care Reform and How to Reform It


Published: April 22, 2010

Though health care reform passed in the House a few weeks ago, that certainly wasn’t the end of the discussion, evidenced by the fact that over a dozen states have begun to file law suits against the federal government on the grounds that the bill is unconstitutional. For Catholics, however, concerns about this bill go much further than just constitutionality.

In the weeks preceding the bill’s passage, one of the loudest voices protesting it was the United States Conference of Catholic Bishops (USCCB). According to the USCCB, the bill was problematic because it allowed federal funding for abortions and didn’t provide adequate conscience protections for health care providers or insurance agencies, and because it didn’t provide adequate coverage for immigrants (both legal and illegal).

The objections of the USCCB seemed to stop there, suggesting that U.S. bishops would endorse the bill, so long as those two changes were made. The fact that other Catholic organizations in America (including a number of Catholic sisters) publicly endorsed the bill didn’t help. A close consideration of Catholic social teaching will demonstrate just how un-Catholic this bill really is.  Any endorsement of it by bishops or other Catholic voices is misguided.

Even though everyone likes to claim the Church for his or her own political party, Catholic social teaching makes it abundantly clear that the Church is neither Democrat nor Republican, neither liberal nor conservative. Instead, it aligns itself with a different mindset grounded in five important principles: dignity, solidarity, charity, subsidiarity (tasks should be handled by the smallest, least centralized authority) and distributism (the means of production should be owned by the people and not by the state or an elite few). Catholic views on labor, economics, community, family, property and government are all rooted in these principles. And while the principles of dignity, solidarity and charity necessitate universal access to health care, the principles of subsidiarity and distributism rule out state-controlled health care as the means by which to attain reform.

In his 1891 encyclical “Rerum Novarum,” Pope Leo XIII condemned unbridled capitalism, calling for a market tempered by charity and respect for human dignity. Though America is not purely capitalist and would more appropriately be called a mixed economy, instances of capitalism and unchecked competition are hard to ignore. A prominent example is the privatized health care system, which is purely profit-oriented, with little charity or regard for the needs and abilities of those lacking insurance. Insurance agencies happily rake in more and more money while being as unhelpful as possible to those who actually need assistance.

But does that mean that the answer is to put the state in charge? “Rerum Novarum” also condemns socialism, saying that too much power in the hands of the state distorts its function and compromises the interests of wage earners. Pope Pius XI’s encyclical, “Quadragesimo Anno,” states that it is a “grave evil and disturbance of right order” to allow a powerful, centralized authority to take control of a matter that would better be handled locally.

Though the words of Dorothy Day regrettably can’t be considered official Church teaching, her solidly Catholic approach gives credit to her words, which warn against the encroaching state: “Certainly we all should know that it is not the province of the government to practice the works of mercy, or go in for Insurance. Smaller bodies, decentralized groups, should be caring for all such needs.” Day goes on to stress the importance of small units of society—the family, the parish, the community and charitable groups—and warns of an increasing reliance on the state to make decisions and provide money.

The fruition of the Catholic social principles of dignity, solidarity, charity, subsidiarity and distributism, while rejecting cutthroat capitalism and the methods of profit-hungry insurance agencies, necessarily fosters an environment with a strong local economy that is sustainable with minimal help from the state. This doesn’t quite fit with the decision we’ve made to incrementally hand over our autonomy to the state and become dependent on it instead of ourselves.

An all-too-briefly considered alternative to publicly funded health care was the idea of health care cooperatives. Health care co-ops are non-profit organizations that combine health care and coverage at affordable prices. They are owned and governed by their own consumers, who therefore mutually insure one another (and also ensure that they, the patients, are the first priority). They are sustainable on a local level and are theoretically able to offer quality health care at more efficient costs due to the lack of profit motive.

When this alternative was considered last summer, there were some concerns with how well new co-ops could compete with large insurers. My guess is that people probably thought of them as new and experimental. In reality, there are well functioning co-ops across the country, like Group Health Cooperative (Washington), Health Partners (Minnesota) and Catholic Healthcare West (California). They function on a large scale while still remaining local by maintaining hospitals and care centers in the states surrounding their locations. Health Partners, for example, serves 1.25 million people. Many of these co-ops make a point of being at the cutting edge of digital technology order to cut administrative costs and stay user-friendly. Several provide their patients with the ability to access medical records online.  They are proof that subsidiarity works: local and sustainable is the way to go. This method of health care reform would be ideal and could lead to the eventual deconstruction of the privatized health care system.

At this point, all we can do is wait. There are several states preparing to sue the government over this new bill, several others calling for it to be repealed and a slew of reforms in its future. No matter how much the bill is reformed, however, the basic principle behind it will likely remain intact. The only true health care reform will come with a fresh bill that restores individual autonomy and localizes health care by way of health care co-ops.